| NPI | 1710475496 |
|---|---|
| Doing Business As | ST. GABRIEL - IDEA BRIDGE |
| Entity Type | Organization |
| Authorized Contact | MARILYN BROWN ANTWINE Compliance Officer 225-642-9676 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-04-27 |